Jerry L Pomeroy, PT
Individual provider Active NPI Physical Therapist · Newton, KS
NPI 1578650321 · NPPES record last updated Feb 17, 2009
Key facts
- NPI
- 1578650321
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-01015 (KS)
- Practice address
- 2311 S Kansas Rd
Newton, KS 67114-9032 - Phone
- (316) 283-7187
- Fax
- (316) 283-7189
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Key Rehabilitation, Inc | Past | Accepting new patients | |
| Advanced PT Hendrickson | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-01015 | KS | Yes |
Addresses
Primary practice location
2311 S Kansas Rd
Newton, KS 67114-9032
Mailing address
200 W Douglas
Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200308300B | Medicaid | KS | |
| P00385870 | Other | KS | RAILROAD MEDICARE |
Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.